- The rates of Cesarean
delivery are on the rise
- One in 10 women is at risk of
C-section scar infection
- Expectant mothers who undergo
C-section are often given a standard antibiotic regimen to reduce
- Administration of an antibiotic azithromycin plus
a standard antibiotic regimen during Cesarean delivery can lower rate of
post-delivery infections by 50%
who go for a Cesarean delivery or C-section
are given a
standard antibiotic regimen, cefazolin
reduce the risk of infection. Physicians at the University of Alabama found
that women given the antibiotic azithromycin alongside the standard antibiotic
regimen had a lower rate of post-delivery infections than women who received
placebo plus standard prophylaxis in a randomized trial.
delivery is the most common major surgical procedure. Women who had C-section
are five times at risk for infection than women who had a vaginal delivery.
C-section infection is one of the top five causes of maternal death in the
United States. Infections increase the rates of readmissions, emergency room
visits, and clinic visits.
‘Compared to women who received cefazolin (standard antibiotic prophylaxis), women who received both cefazolin and azithromycin were 50% less likely to develop infections.’
Dr Alan T. N.
Tita, the professor in the UAB Division of Maternal-Fetal Medicine and the
Center for Women's Reproductive Health, said, "Infection during pregnancy and
during the post-pregnancy period is a major health problem for both mom and
baby and a common underlying cause of death."
Antibiotic Azithromycin Reduces Risk of C-section
Incision Infection and Endometritis
clinical trial was conducted across 14 hospitals in the United States. The
trial included 2,013 women who were more than 24 weeks' gestation and
undergoing a C-section during labor or after membrane rupture.
participants were randomly divided into two groups. One group received the
standard antibiotic regimen to prevent infection. The other group received a
modified regimen with the additional antibiotic azithromycin. The data gathered
from the 14 hospitals were analyzed by the UAB Department of Biostatistics. The
results showed that the rates of endometritis (infection of the lining of
the uterus) and infection of the cesarean incision reduced by 50% in women who
received azithromycin and cefazolin,
compared to women who received only the standard
single antibiotic. Babies born to women who received additional azithromycin
did not have an increased risk of adverse events. The researchers also found
that the rates of hospital readmission, unscheduled clinic visit, and visit
to the emergency room were reduced in the group that received azithromycin.
"When our group
first developed the idea that a second antibiotic could help reduce infections
for these women, we found reassurance in the fact that some patients who have
preterm premature rupture of the membranes receive two antibiotics to help
reduce infection and prolong pregnancy," said Tita.
significant costs associated with infections. The reduction in the rates of
readmissions, visits, fevers and overall antibiotic use due to the intervention
was higher than we expected, and translates to reduced health care costs," he
Ph.D., associate professor in the UAB School of Public Health Department of
Biostatistics, said, "The benefits associated with the additional antibiotic
azithromycin are consistent across several subgroups of patients. Thanks to the
dedication of research staff across the consortium of 14 centers to
successfully execute a clinical trial of this magnitude, we are poised to
perform multiple follow-up investigations and to understand the ramifications
of these results more completely."
"This was a
significant breakthrough that has identified a simple and inexpensive way to
reduce the most common complication associated with cesarean delivery," said Dr
William Andrews, chair of the UAB Department of OB/GYN and chair of the
Steering Committee for the study.
Dr Uma Reddy,
the NICHD project officer for the study, said, "These results are crucial,
given that the maternal death rate has increased in the US
and there is an urgent need for therapies to decrease serious complications
that can lead to maternal deaths."
The trial was
funded by the Eunice Kennedy Shriver National Institute of Child Health and
Human Development. The antibiotic azithromycin was donated by Pfizer. The study
is published in the New England Journal of Medicine.
C-section is a
surgical procedure to deliver a baby. The baby is taken out through an incision
in the mother's abdomen. A C-section is planned when the pregnant woman
develops complications. About 3 to 6 percent of women who have undergone a
C-section are vulnerable to infections. C-section infection can occur due to
lack of hygiene. Obese and overweight women are at high risk of getting
C-section wound infected. Women who had pregnancy complications
such as gestational
diabetes, high blood pressure, and autoimmune disease are also at high risk for
Tips to Care
After a C-section
- Swelling or redness at
- Fever rises to more than 100.4°F (38°C)
- Abdominal pain and discomfort
- Take rest when
- Avoid lifting anything
- Drink plenty of fluids
- Maintain good posture while walking and standing
- Keep the wound site clean and dry
your abdomen during coughing and sneezing
- C-section recovery: What to expect -